Provider Demographics
NPI:1417609330
Name:EL PASO RHEUMATOLOGY ASSOCIATION
Entity Type:Organization
Organization Name:EL PASO RHEUMATOLOGY ASSOCIATION
Other - Org Name:EL PASO RHEUMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELL
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTARRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-256-9751
Mailing Address - Street 1:211 BARTLETT DR STE 108
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1607
Mailing Address - Country:US
Mailing Address - Phone:915-642-9595
Mailing Address - Fax:866-611-9943
Practice Address - Street 1:211 BARTLETT DR STE 108
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1607
Practice Address - Country:US
Practice Address - Phone:915-642-9595
Practice Address - Fax:866-611-9943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-21
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty